Hands-on training is a widely accepted methodology, especially for learning clinical procedures as they can be complicated and difficult to master. Virtual Reality (VR) based training systems can be highly successful in training operators because they can be accessed anytime anywhere as a refresher without the need for a human expert, can simulate various scenarios, can objectively monitor a trainee's performance and provide feedback. Yantric, Inc proposes to develop a comprehensive hands-on virtual reality based system for clinical education and training in order to improve training effectiveness and patient safety. In this collaborative effort involving medical experts in three medical centers, we will develop a virtual reality based central line placement trainer with integrated touch feedback. Yantric has vast experience in developing medical simulation systems and we will take full advantage of our existing hardware and software architecture for the design and development of this system. At the end of this project, the system will consist of the following key components. (1) A customized training system containing a haptic interface that allows the user to insert real instruments, such as needles and catheters while receiving touch feedback. (2) A medical simulation and training system for the infraclavicular central line procedure with 3D Anatomical Viewer and ultrasound guidance. (3) General user interface and didactic content presentation that is internet browser based, developed with HTML/CSS and capable of user's performance recording and evaluation. (4) A virtual reality based medical trainer that is verified in terms of content and validated for training effectiveness with experts and medical residents. In terms of commercial potential, there is a large demand for virtual reality based medical trainers for needle and catheter insertion procedures in general and regional anesthesia procedures in particular. An increasing number of central line placement procedures are being performed by anesthesiologists, intensivists, cardiologists, surgeons and interventional radiologists and each procedure is complex enough that there is a strong demand for a good training simulator. Once our training system is developed, it can be installed at educational facilities, medical institutions, hospitals, urgent care or health care centers, clinics, laboratories, and radiology centers. PUBLIC HEALTH RELEVANCE: The proposed hands-on virtual reality based medical training system is expected to radically transform how medical trainees gain expertise in performing infraclavicular central line placement procedure in particular and complex needle and catheter procedures in general. This in turn will decrease the number of complications in the operating room and increase the number of successful cases leading to better patient care.